Decreasing Neuroleptic Doses in Older Adults with Schizophrenia

This prospective study of 27 older adults, residing in long-term care facilities, examined the effects of reducing neuroleptic medications to the point of controlling symptoms and reducing side effects. Schizophrenia is a challenging health care condition that leads to delusions, hallucinations, disorganized speech, and a host of other symptoms. Unfortunately, medications control many of the symptoms but cause unwanted side effects unless monitored closely and regulated to each person's needs. This study addresses six research questions related to the reduction of neuroleptic medications. Study findings related to neuroleptic medication dose reduction were encouraging. Additionally, the findings strongly suggest that health care providers working with older adults with the diagnosis of schizophrenia would benefit from planned educational programs about behavior, observations, and medications.     

Typical Development of Roles and the Impact of Schizophrenia on the Development of Adult Social Roles

Abstract

This chapter is a literature review that explores the nature of interaction between parents and children with emotional disorders, issues between parents and professionals when children are psychiatrically hospitalized, and the nature of parent involvement in child psychiatric settings.     

A Meta-Analysis of Cognitive Deficits in Adults with a Diagnosis of Schizophrenia

This review identified 1275 studies examining cognitive deficits in people with schizophrenia, published between 1990 and 2003. Data from 113 studies (4365 patients and 3429 controls) were combined in a meta-analysis carried out on the five cognitive domains of IQ, memory, language, executive function, and attention. Studies were excluded where they lacked a suitable control group or failed to present complete information. In all five cognitive domains, analysis indicated a consistent trend for patients to perform more poorly than healthy controls, with significant heterogeneity across studies. Sources of heterogeneity were analyzed and a need to ensure more appropriate composition of patient and control groups and to adopt a more refined and methodologically correct, hypothesis-driven approach was identified.     

Development and Validation of an Adjective Check List to Assess the Millon Personality Types in a Normal Population

A 405-item experimental Personality Adjective Check List (PACL) was refined into a 153-item form to assess the personality types outlined by Millon (1969, 1981) in a normal population. Scale construction and validation followed a method outlined by Loevinger (1957, 1972). Nine scales were developed based on the responses of 459 men and women, one for each of Milton's eight basic personalities plus an Experimental scale measuring aspects of his three more severe types. Extensive reliability and validity analyses were conducted involving over 2,200 men and women from across the United States, including a factor analysis of scales. These revealed good internal consistency for each scale, good test-retest reliability over a 3-month period, adequate factor structure, and good convergent and discriminant validity based on self-report data. Results indicated that Millon's basic types exist in normal form much as they are postulated to exist as disorders. Research efforts focusing on Millon's theory as it applies to normals may bring a more complete understanding of the entire spectrum of personality.     

Adolescents' Reactions to the Evacuation of the Sinai Settlements: A Longitudinal Study

This study investigated psychological reactions of adolescents to a severe stress situation—the evacuation of the Sinai settlements. The research focused on emotional reactions of anxiety and anger to this stress situation. Two central problems were investigated: (a) The intensity of the emotional responses of anxiety and anger of the adolescents to the stress situation, before and after the evacuation, and (b) the impact of three intervening variables on these emotional reactions—cognitive perception of the political situation, family functioning, and personality characteristics. Data for this study were collected in a regional high school in Israel from 418 pupils in 9th through 12th grades. Seventy-eight of the pupils lived in the Yamit area. Measurements were obtained at three points in time: 6 weeks and 1 week before the evacuation and 2 months after it. The results supported the predicted trend that adolescents in the Yamit group before the evacuation would score higher on state anxiety and state anger than would those in the comparison group. Two months after the evacuation there was a significant drop in those scores. The trait measures remained stable in both groups and no significant differences were found between the two groups on these scores. Concerning the impact of the three intervening variables on the intensity of the state emotional responses, the results did not support any of the hypotheses.     

催产素对产后抑郁症患者母性行为的调节作用

产后抑郁症是指女性分娩后一段时间内出现的严重抑郁发作现象。研究表明, 催产素不仅参与分娩过程和正常的母性行为表达, 也在调节产后抑郁的发病及患者的母性行为中起到了重要的作用。产后抑郁症患者的情绪和认知功能受损, 这可能导致了母性行为表达质量的下降; 催产素可以通过中脑边缘多巴胺系统来调控母性行为, 作用于内侧视前区(MPOA)来激活中脑腹侧被盖区(VTA)-伏隔核(NAc)环路从而影响伏隔核内多巴胺的分泌; 催产素对产后抑郁症中母性行为的调节机制可能是通过调节五羟色胺系统的功能来发挥抗焦虑作用, 也可能是通过与其它激素的交互作用来加速母性行为的表达。未来研究进一步明确催产素在中枢神经环路中的功能差异, 以及社会支持对产后抑郁症患者催产素的使用带来的影响。     

Parent Care in the Context of Women's Multiple Roles

This article addresses the multiple roles held by women involved in parent care and the ways in which these roles affect the women's well-being. Research on women's roles (including that of caregiver) has been guided by two opposing perspectives, the scarcity hypothesis and the expansion hypothesis. Findings from our studies of role quality, role combinations, and role spillover have provided abundant evidence that the lives of these women cannot be easilycaptured by either the scarcity or the expansion hypothesis alone.     

The Impact of Experience with the Aged upon the Time Perspective of Young Adults

With the use of questionnaire returns from 214 male and 286 female upper-year high school students, a model of adolescent drug use is proposed. The model hypothesizes that the parents' child-rearing practices produce within the child a personality which shapes his attitudes toward the use of drugs, which in turn affect the child's use of marijuana, alcohol, and tobacco. The personality dimension in the model is Authoritarianism. The model proved more successful in predicting illicit than licit drug use. Further, love on the part of the mother and positive control on the part of the father were the most salient dimensions within the model with regard to child-rearing practices.     

Linkage from Self-Sacrifice to Hope Through the Intervening Roles of Perceived Family Support and Attitudes to Aging in Chinese Older Adults

Journal of Happiness Studies - The objective of this study was to examine the relationships between self-sacrifice and hope as well as the possible intervening roles of perceived family support and...     

Her heart is in the right place: an investigation of the ‘heartbeat hypothesis’ as an explanation of the left side cradling preference in a mother with dextrocardia

A majority of mothers, whether right- or left-handed, exhibit a preference to hold their babies to the left of the body midline. One of the earliest explanations for this finding proposed that babies were being held close to the mother's heart [Salk, L. (1960). World Mental Health, 12 , 168–175]. Salk suggested that the foetus becomes imprinted on the sound of the maternal heartbeat in utero. This paper reports a left holding preference in a mother who has the heart positioned on the right rather than the normal left side of the body. Salk's ‘heartbeat hypothesis’ is not supported by the holding preference of the dextrocardiac mother, nor by the detailed patterns of holding in the control group. © 1998 John Wiley & Sons, Ltd.     

Time and Its Relationship to Development in the Life Course: Some Reflections from a Study of HIV-Positive Adults

Although adult development is commonly understood as change over time, the relationship between time and development is rarely highlighted in research in the field. This paper first reviews 3 dimensions of time that interact in the study of developmental processes in the life course. The 3 dimensions are historical time; chronological age or life time; and social time, the culturally-specific, systematic ordering of life events. Second, the paper utilizes data from a follow-up study of HIV-positive men and women to illustrate the importance of time in development. In the original study, an HIV-positive diagnosis was viewed as a death sentence and had the effect of suspending the normal developmental patterns of adult life. Two years later, with the advent of protease inhibitors—an event in historical time—participants had reengaged with life time, once again making social time a relevant factor in their development. These data demonstrate how a better understanding of adult development can be achieved when historical time, life time, and social time are moved center stage in the study of developmental processes.     

The Mutual Development of Intersubjectivity and Metacognitive Capacity in the Psychotherapy for Persons with Schizophrenia

While cognitive behavioral approaches have been shown to help some individuals with schizophrenia, these approaches may be limited when working with patients with impairments in the metacognitive abilities required to form complex and integrated representations of themselves and others. In response, this paper explores the possibility that a key to working with patients with relatively impaired self-reflectivity lies in explicitly focusing on a patient’s intersubjective experience within psychotherapy. We offer theoretical and empirical support for the assertion that the tolerance and capacity for intersubjectivity is a basis for the development of self-reflectivity in general. We also explore how the fostering of intersubjective processes in psychotherapy might enable some patients to form more complex ideas about themselves and so better ward off delusions in the face of the challenges of daily life. To illustrate these principles we present the case of a patient with tenaciously held delusions and limited capacity for self-reflection. We discuss when and how the therapist’s awareness and verbalization of intersubjective processes within session allowed her and the patient to develop more complex and consensually valid ideas about him as a being in the world, which then assisted the patient to achieve improvements in a number of domains in his life.     

Poverty Among Adults with Disabilities: Barriers to Promoting Asset Accumulation in Individual Development Accounts

Adults with disabilities disproportionally experience poverty. We examine one novel strategy to promote economic well-being among adults with disabilities living in or near poverty, namely Individual Development Accounts (IDAs). IDAs are designed to help individuals save money and subsequently accumulate assets. Although adults with disabilities account for the majority of IDA participants, scant attention has been paid to their IDA saving performance. We describe the significance of accumulating assets, particularly as it relates to adults with disabilities. We then map the nature of IDA programs and analyze barriers to participation in IDAs and asset accumulation related to conflicting federal policies and a lack of sensitivity to disability-specific needs. We conclude by offering policy recommendations from our analysis, including the need to eliminate the means-tests used in welfare policies, de-linking participation in IDAs from employment status, and involving people with disabilities in designing and evaluating asset accumulation policies and programs.     

Partnering with Children Diagnosed with Mental Health Issues: Contributions of a Sociology of Childhood Perspective to Participatory Action Research

This paper explores the use of participatory action research (PAR) with children diagnosed with mental health issues. We argue that critiques from the sociology of childhood are useful for guiding PAR with children. First, we describe and critique values and assumptions that underlie research and practice with children who experience mental health issues. Second, we outline key qualities of the sociology of childhood, discuss their implications for PAR with children diagnosed with mental health issues, and touch on ethical issues. Five themes are explored: (a) values, (b) ontology/epistemology, (c) views about children, (d) agency/power in children’s relationships with adults, and (e) intervention/change focus. We conclude by encouraging community psychologists to consider PAR with children diagnosed with mental health issues.     

The Role of Personality Profiles in the Longitudinal Relationship Between Work-related Well-being and Life Satisfaction Among Working Adults in Switzerland

Drawing on the concept of spillover between work and life domains and using a person-centred approach, the present study examined the role of Big Five personality trait profiles in moderating the relationship between work-related well-being and life satisfaction over a 1-year period in a sample of working adults in Switzerland (N = 1204). Latent profile analysis was first carried out to derive and compare alternative latent personality profile models. Subsequently, a two-wave cross-lagged structural equation model using three personality profiles (resilient, average, and oversensitive) as moderators was tested. Work stress and job satisfaction were used as negative and positive indicators of work-related well-being. The results showed that in the overall sample, only Time 1 life satisfaction predicted Time 2 job satisfaction. We found a moderating role for the personality profiles, where the effect of Time 1 work stress on Time 2 life satisfaction became salient in the oversensitive profile, while a significant effect of Time 1 life satisfaction on Time 2 work stress was found in the resilient profile. The current study showed that different combinations of personality traits may determine the way in which work-related well-being and general well-being relate to each other. © 2019 European Association of Personality Psychology     

概化理论在内科学临床技能考核中的应用研究

运用多元概化理论对两届临床医学硕士研究生内科临床实践能力考核进行评价比较。结果表明,两届研究生内科临床实践能力考核的信度均较高,可靠性指数分别为0.78878、0.67985,考核内容较全面。比较发现,01级学生考核的信度要高于02级,考核专家以3-5位为宜。     

抑郁自我图式研究范式进展

探讨了Beck抑郁自我图式的研究方法及其优缺点。根据抑郁图式认知分类系统,从认知结果变量和认知过程变量两方面对抑郁自我图式研究方法进行了综述。提出了抑郁研究的认知实验范式较传统的问卷测量的优势,同时展望了抑郁认知实验研究和脑成像技术结合的发展未来。